The first warning for Leonor, grandmother of “Itzi,” a 13-year-old girl she is caring for, was that her granddaughter had behaviors that she did not normally have before, she was distancing herself from everyone, she did not want to eat, she stopped wanting to go to her extracurricular activities and finally she discovered that she was self-inflicting cuts on her arms. She thought it was her age and let it go, two months later she had to rush to the emergency room with her granddaughter after she ingested a large amount of medication that put her life in danger.
Itzi, as her grandmother affectionately calls her, was lucky and did not die, but today Leonor blames herself for not paying more attention and for ignoring the signs.
Suicide is a serious public health problem across all age groups. Among young people, it takes a huge toll due to the significant years of potential life lost. In 2020 alone, suicide was the second leading cause of death among people aged 10-24 and 25-34.
This is what the organization reports America's Health Rankings, who points out that, in addition to those who die by suicide, there are many more adolescents who have suicidal thoughts or attempt suicide and survive.
Youth suicidal ideation, attempt, and completion are on the rise. Results from the 2019 Youth Behavioral Risk Factor Surveillance System show that 18.8 percent of high school students seriously considered attempting suicide, while 8.9 percent actually attempted it.
The organization estimated the cost of suicide in the United States in 2019 at $926 billion in medical costs, lost productivity and the value of statistical life.
Statistics show that the rate of adolescent suicide is higher among boys compared to girls. However, girls attempt suicide more frequently than boys.
American Indian/Alaska Native adolescents have the highest suicide rates among all other racial and ethnic groups, followed by white adolescents, and then those from Asian, Pacific Islander, Hispanic, and African-American communities.
The numbers show that suicide attempts are higher among students who identify as gay, lesbian or bisexual compared to students who identify as heterosexual.
Healthy People 2030, part of the U.S. government’s Office of Disease Prevention and Health Promotion (OASH), which sets data-driven national goals to improve health and well-being over the next decade, notes that the situation with teen suicide continues to worsen.
As of 2019, the latest data on the matter available from the federal agency, there were 8.9 suicide attempts per 100 inhabitants, while in 2017 there were 2.4 per 100 inhabitants. The goal for 2030 is 1.8 per 100 inhabitants.
The most affected states in the United States are Montana, Idaho, Wyoming, South Dakota, Utah, Colorado, New Mexico, Oklahoma, Alaska and West Virginia, followed by North Dakota, Oregon, Nevada, Arizona, Kansas, Iowa, Missouri, Arkansas, Kentucky and Vermont.
Without specifying the age, ethnicity or race of those who have committed suicide so far in 2022, the Gun Violence Archive notes that according to the Centers for Disease Control and Prevention (CDC), from January 1 to December 3 of this year, 22,374 suicides involving firearms have been recorded.
Earlier this year, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a National Child Mental Health Emergency after they observed that the COVID-19 pandemic had intensified the teen suicide crisis.
“We are serving young people with skyrocketing rates of depression, anxiety, trauma, loneliness and suicidality that will have a lasting impact on them, their families and their communities. We must identify strategies to meet these challenges through innovation and action, using state, local and national approaches to improve access and quality of care across the continuum of mental health promotion, prevention and treatment,” they said in a joint letter as a call to policymakers at all levels of government and child and adolescent advocates.
Leonor, a Mexican immigrant who does not have residency, told Peninsula 360 Press that navigating between clinics, doctors, psychologists and psychiatrists has not been easy for her and her granddaughter.
“Getting real and good help is not easy. The costs “outside” are very high and we don’t have insurance that helps us pay for medicines, specialists and therapies. As immigrants we are alone and on our own, but while our children are dying. Sometimes I feel very desperate and I also went into crisis, but I will do whatever it takes to help my daughter,” she said.
«I don't know about social media and all that stuff, but I had to learn. She was always there and didn't want to let go of the phone. I feel like that hurt her even more. She would stay up until 3 or sometimes 4 in the morning. How long does she stay there? I asked her and she told me that I didn't care and that they were her friends. Now I'm more into that. Organizations helped us. She has her phone back, but now there are rules and she knows that you can't do it all the time. It's very difficult to know how to help our young people, but you can. Seek help,» added Leonor.
For Dr. Megan Moreno, professor of pediatrics at the University of Wisconsin-Madison and principal investigator of that university's research team on social media and adolescence, social media amplifies the anxiety that adolescents have.
The specialist pointed out to the non-profit organization AARP that the near normalization of suicide on social media could be influencing what happens in real life.
“There is a contagion effect. If someone in their very remote social network tried to commit suicide, the young person will hear about it and realize that many people are doing it,” she said. “Suicide is presented as an option; that is the unparalleled power that social media has that other types of media have not had before.”
At the same time, however, she said, social media also offers young people an outlet for their emotional challenges. In a 2020 study, 43 percent of respondents aged 14 to 22 said that when they felt depressed, stressed or anxious, turning to social media generally made them feel better, compared to just 17 percent who said it made them feel worse.
Among young people, those with moderate or severe symptoms of depression are almost twice as likely as those without depression to say they use social media “almost constantly.”
“A lot of people are surprised that social media has become a place where talking about mental health is not a problem,” Moreno said. “I think that has had a big impact on stigma. It’s more acceptable; it’s okay to ask for help.” But asking for help is not the same as receiving it.
Lack of resources
While there is no denying that there is a mental health crisis among children in the country, there is also no denying that there are no resources to address it. According to the most recent National Mental Health Services Survey, the number of residential treatment centers for children under 18 years of age decreased by 30 percent between 2012 and 2020, while outpatient mental health care is experiencing a similar crisis.
As a result, of the approximately 4.1 million adolescents who experienced a period of major depression in 2020, 58.4 percent did not receive any treatment. Among the 2.9 million children whose depression caused “severe deterioration,” 53.1 percent did not receive treatment.
Earlier this year, following a shooting at an elementary school in Uvalde, Texas, Congress passed bipartisan legislation to make significant investments in youth mental health. $1 billion will be dedicated to funding psychological support in school settings over five years, in addition to other resources.
Pay attention
Risk factors associated with suicide among adolescents include psychiatric disorders such as major depression, bipolar disorder, substance use and conduct disorders; psychiatric comorbidity, especially the combination of mood, disruptive and substance use disorders; family history of depression or suicide, loss of a parent through death or divorce, physical and sexual abuse, lack of a support network, feelings of social isolation, and bullying.
Youth suicide is preventable. Prevention efforts can be directed at all levels of influence: individual, relational, community, and societal. Suicide rates for at-risk youth can be substantially reduced by knowing the signs.
Four out of five suicide deaths are preceded by warning signs such as suicide threats, previous suicide attempts, depression, preoccupation or obsession with death or making final arrangements.
Making it harder to die in an act of deliberate self-harm. Interventions include building barriers on bridges, removing guns from homes with at-risk youth, counseling on lethal means, and reducing the burden of available medications.
If you or any of your family members or friends are having suicidal thoughts, remember that since July of this year you can call or send a text message to 988, the National Suicide Prevention Lifeline, which works 24 hours a day, 365 days a year.
Pamela Cruz. Editor-in-Chief of Peninsula 360 Press. A communications expert by profession, but a journalist and writer by conviction, with more than 10 years of experience in the media. Specialized in medical and scientific journalism by Harvard and winner of the International Visitors Leadership Program scholarship from the U.S. government.
Twittter: @Pamesmiamiga
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